ANSC September 2022 update: RPA Women and Babies/Canterbury Hospital

Upcoming GP orientation session, open to existing ANSC GPs

The RPA Women and Babies/Canterbury Hospital ANSC Orientation Session will provide an overview of the ANSC program, GP responsibilities and education requirements, and information on where to access clinical information and support including details on SLHD midwifery services and referral pathways. This session will also include details about the new SLHD Maternity, Gynaecology and Fertility e-referral system.

The webinar is open to existing RPA/Canterbury ANSC GPs as a refresher training session. GPs will accrue 3 ANSC CPD points for attending this session.

The session is scheduled for Thursday October 20^th, 7-8:30pm. Register via this link.

Discharge summaries on MyHealthRecord

ANSC GPs are reminded that hospital discharge summaries are available via their patient’s MyHealthRecord. This includes ED presentations, EPAS admissions and well as postnatal discharge summaries. Summaries are uploaded to MyHealthRecord within 24 hours of discharge.  

If you are having trouble accessing discharge summaries, please contact the GP Shared Care Midwife Melanie Tulloch on 0425 230 662 (Monday to Friday 8am-4:30pm).

Filling out the yellow card antenatal record

Please encourage women to bring their yellow card to all ANSC GP and hospital appointments.

At each GP visit, document key clinical information on the yellow card including BP, fundal height, fetal movement, fetal heart rate and any other relevant information including results and pathology tests ordered.

HealthLink Smartform E-Referral to RPAH Women and Babies Services

GPs are now able to use HealthLink SmartForms from their practice software or the HealthLink portal to launch e-Referrals to the following services:

• RPAH Fertility
• RPAH Gynaecology
• RPAH Maternity

For GPs without Best Practice, Genie or Medical Director practice systems, referrals can be lodged using the HealthLink portal, or via fax using the new fax coversheet which enables digitisation of your faxed referral.

In addition to results being sent via Healthlink with referral forms, GPs are encouraged to email results to patients so they can bring them to all hospital appointments.

Case Study: Pre-Conception Planning in T2DM

Read the full case study via this link (RPA Case Study)

Canterbury Hospital Hypertensive/Renal Disorders of Pregnancy Clinic now accepting GP referrals

Canterbury Hospital Maternity has a Hypertensive/Renal Disorders of Pregnancy (HDP) Clinic, run by renal physicians Dr Lucy Wynter and A/Prof Adrian Gillin. The clinic runs weekly on a Friday afternoon in the antenatal clinic area of Canterbury Hospital.

The HDP clinic welcomes referrals from all community settings. Please fax all non-urgent referrals to 9787 0431. Urgent referrals should be discussed with the Birth Unit Obstetric Registrar as per current protocols.

HDP Clinic Referral Criteria

1. Pregnant women (preferably prior to 16 weeks) with:
   1. chronic hypertension
   2. preeclampsia in a previous pregnancy
   3. any renal disease including Chronic Kidney Disease (CKD) (with the exception of Transplant patients who should continue to see their transplant physician)
2. Pregnant women:
   1. with preeclampsia, gestational hypertension or elevated blood pressure (>140/90) on any antihypertensive medications
   2. with pyelonephritis
3. Postpartum women who:
   1. had difficult to control hypertension during pregnancy
   2. had preeclampsia during pregnancy (up to max 12 weeks postpartum)
   3. have persistent renal abnormalities (e.g proteinuria, recurrent UTIs or pyuria)
   4. had hypertension or preeclampsia who were transferred to or delivered at RPAH but are local to the Canterbury area and would prefer to return
4. Women planning pregnancy who have:
   1. a history of preeclampsia or hypertension
   2. a history of any renal disease

Information about referral to the clinic will soon be available on HealthPathways and the CESPHN website.

If you require further information or assistance with referrals, please contact the GP Shared Care Midwife Melanie Tulloch on 0425 230 662 (Monday to Friday 8am-4:30pm).

SLHD Parent Education Sessions
SLHD Parent Education offers a wide variety of information sessions for expectant and new families.

The Early Pregnancy session covers what to expect in early pregnancy, staying healthy, models of care, useful resources and services available within the district. An experienced midwife is available to answer your questions. Suitable from 6 weeks.

The Changing Shape session provides information for pregnant women about their changing body, back and pelvic floor care and exercises. An experienced Women’s Health Physiotherapist is available to answer your questions, as well as how to manage common pregnancy ailments. Suitable from 12 weeks.

CPR Kids involves experienced paediatric nurses provide CPR and first aid training for families of children aged 0-8 years. All sessions are currently run via ZOOM.

More information is available on the SLHD Childbirth and Parenting Programs website. Booking are essential via the web form or email SLHD-RPAParentEducation@health.nsw.gov.au

Birth Course online course and research has started at RPA

Birth Course is an evidence-based antenatal education program that incorporates information about physiological birth process, and how these are supported with complementary therapy techniques, working within the hospital system. The complementary therapy techniques taught in BirthCourse include acupressure, movement and upright positions, massage, breathing and relaxation techniques and guided visualisation. There is also an emphasis on birth partner participation and support during the course. 

The main aims of the program are to; i) provide knowledge and understanding (of normal physiological/hormonal birth) and common occurrences during labour, ii) create a positive mindset (building confidence for women and their partners through psychological preparation), and iii) providing non-pharmacological techniques for pain relief (through evidence-based tools and techniques for use during labour and birth).

In a pilot randomised study, outcomes comparing the study group who attended BirthCourse (called Complete Birth then), in addition to usual care, showed a signification reduction in rates of epidurals (65% reduction) and caesarean section (44% reduction) compared to a control group who attended usual care alone, including usual antenatal education. 

The Birth Course program is now part of a larger prospective meta-analysis to further assess clinical effectiveness, quantify resource use and establish cost-effectiveness.

This free online course is in addition to the courses offered by SLHD Parent Education and does not replace them. Please scan the QR code on the flyer to gain more information and check eligibility.

First Trimester Screen available at RPA Fetal Medicine Unit

GPs can refer women to receive the combined First Trimester Screen (nuchal translucency/fetal anatomy ultrasound and pre-eclampsia screen at 11⁺⁰-13⁺⁶ weeks gestation) at the RPA Fetal Medicine Unit. This service is bulk-billed for patients with Medicare. Pre-eclampsia screening alone is available for women who do not want aneuploidy screening. Women who screen as high risk for early onset pre-eclampsia (>1 in 100) are advised to start low dose aspirin. Referral information is available on the Preconception and Pregnancy Assessment Services HealthPathway.

Please note that the NIPT is not a replacement for the First Trimester Screen. Women are advised to attend a First Trimester Screen even if they have already returned a low risk NIPT result. Please see the Screening for Fetal Chromosomal Conditions HealthPathway for further information.

Dr Ritu Mogra and Dr Jose Flores from the RPA Fetal Medicine Unit recently provided an ANSC Obstetrics Update on First Trimester Screening and non-invasive prenatal testing (NIPT). A recording of this session is available on the CESPHN YouTube channel.